Status of Hepatitis B Virus Serological In Patients With Multipl Sclerosis Using Ocrelizumab
Abstract
Objective: B-cell depleting treatments are associated with potential risks of viral infections. Hepatitis B virus (HBV) infection is the most common chronic viral infection and it is estimated that 30% of the world population has serological evidence of current or past infection.
Material and Methods: Our study is a single-center, cross-sectional study. We retrospectively reviewed the clinical records of MS patients receiving ocrelizumab. Demographic and clinical characteristics of patients, Expanded Disability Status Scale (EDSS), drug history before ocrelizumab for MS; Mean ocrelizumab intake times, smoking status, hepatitis C virus, HIV serological status, HBV serological status, HBV treatment status were recorded.
Results: The study included 64 MS patients treated with Ocrelizumab. The mean age was 41.6±9.8 years (min-max: 21-62 years). 75% of the cases were female (n:48), 25% were male (n:16). HIV and hepatitis C virus serological tests were negative in all cases. HBsAg was found to be positive in 1.6% (n:1) and Anti-HBcIgG in 12.5% (n:8). The number of patients who were started on hepatitis B treatment was 12.5% (n:8), and tenofovir disoproxil was started in 2 patients (25%), entecavir in 5 patients (62.5%), and tenofovir alafenamide in 1 patient (12.5). The mean duration of taking ocrelizumab for the patients was 28.5±13.1 months (min-max: 6-46 months).
Conclusion: In conclusion, all patients should be screened for HBV before starting ocrelizumab therapy. Both HBsAg and Anti-HBcIg G tests should be used. The isolated presence of Anti-HBcIg G may cause HBV reactivation. Therefore, Anti-HBcIg G should be screened before immunosuppressive therapy
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